Originally Posted by ekdk92 (Post 1130936)

This policy means the Villages Health is not available to anyone under age 65.

Doesn't seem to fit the needs of a 55 and over community.

Originally Posted by golfing eagles (Post 1130972)

I don't think it is clear from this thread that TV Health is closed to anyone under 65. If it is, it is a poor business decision in the long run. From a practical point of view, sign up an 18 year old and you may have a patient for the next 80 or 90 years. Sign up a 99 year old and ........

Originally Posted by bimmertl (Post 1130988)

The policy is that new patients must enroll in UHC Medicare Advantage to be accepted in the Villages system, you can't do that unless you qualify for Medicare so you have to be 65. Where is the grey area?

Originally Posted by golfing eagles (Post 1130999)

The grey area is whether the policy applies to ALL new patients or all new patients that are medicare eligible.
Most medical practices actively seek younger patients with private insurance, some will not take anymore medicare patients, so to close a large practice to all but those over 65 with UHC MA is somewhat counterproductive. Do you know for a FACT that they are not taking anyone under 65??

Originally Posted by NYGUY (Post 1131016)

I thought it was very clear that NO NEW patients will be accepted unless they have a UHC Medicare Advantage Plan (that would be their Advantage HMO or PPO). I believe that means you have to be at least 65 or have qualified under the SS disability provisions)

Originally Posted by memason (Post 1131071)

Not sure this is all accurate.....My wife and I are not 65 yet and we both go to The Villages Health Care. We just recently signed up and have initial appointments in May, although I have already been to the audiologist there a few times.

They have no problems with our insurance carrier...

Originally Posted by outlaw (Post 1131081)

Same here....but, when you reach 65 and are eligible for medicare, they may tell you that you have to go on UHC medicare advantage versus medicare. Pluses and minuses for both types. I have already received an email that tells me to get with them to "discuss" insurance options when I reach medicare eligibility.

Originally Posted by golfing eagles (Post 1131084)

I'm under 65 with BC/BS My wife is over 65 with traditional medicare/UHC supplemental. We both signed up last week

Originally Posted by golfing eagles (Post 1131084)

I'm under 65 with BC/BS My wife is over 65 with traditional medicare/UHC supplemental. We both signed up last week

Originally Posted by outlaw (Post 1131081)

Same here....but, when you reach 65 and are eligible for medicare, they may tell you that you have to go on UHC medicare advantage versus medicare. Pluses and minuses for both types. I have already received an email that tells me to get with them to "discuss" insurance options when I reach medicare eligibility.

Originally Posted by dotti105 (Post 1129213)

I put much of the blame for our current confusion and chaos in healthcare squarely on the back of the Insurance Industry.

I am a RN and have watched, like many others out there, as Insurance companies made the decisions regarding which provider a patient could see, and making frequent changes in the list of allowable providers. ( As well as restricting medications and increasing co pays out of sight for non formulary drugs for example)

We were very concerned about the standard of health care we would receive once on Medicare. Fortunately we have been very impressed and pleased with the standard of care we receive at TV on UHC Villages Advantage plan.

We have also been able to see the specialists we have selected thus far as they have all accepted our Medicare Advantage Plan.

My father was a MD and I remember the day he walked in after work and said that the Insurance Companies had a choke hold on Doctors, Hospitals and patients. He passed away before it got really ugly.

I personally am still praying for a single payer system for all, a Medicare for all. If all the young healthy people in our country were put into the same system the cost for all would go down. WE are the ones who create the highest costs in the healthcare system. But as long as the Insurance Companies can control our health care it will be a series of changes, cuts, buyouts and profits are the name of the game.

The fact that a few Insurance companies can band together, through buy outs and mergers, and excluding other companies patients, will make having predictable convenient and dependable healthcare very difficult. It hurts us all, the providers and the patients.

Originally Posted by outlaw (Post 1131094)

Look for the infamous email. You will get it.

Originally Posted by golfing eagles (Post 1131019)

And from their update web page:

If you are eligible for Medicare, we want you to know that the only Medicare Advantage plans The Villages Health participates in are those offered by UnitedHealthcare®.
•UnitedHealthcare® The Villages® MedicareComplete® (HMO)
•AARP® MedicareComplete Choice® (Regional PPO)

Please note the first word---IF. So I still think it's unclear, I'm sure it will be made more clear in the coming days

Originally Posted by golfing eagles (Post 1131129)

If this is their intention, they better send it before Dec 7

Originally Posted by outlaw (Post 1131220)

Why dec 7?

Originally Posted by FromDC (Post 1131237)

READ the following article. It is dated September 2014, but it is oh so relevant for today. The article talks about the Villages Advantage Plan as being a revenue generator:

**University of South Florida backed out from running the specialty care clinic due to lower than expected sales of the Plan.

**The business model relied on getting enough patients enrolled in the Plan. Only 6,000 enrolled, but they needed 20,000 enrolled the first year.

USF pulls out of its $4 million specialty care clinic at the Villages | Tampa Bay Times

If you want to enroll in this Advantage Plan because of Villages Health, go ahead. You will be helping their income stream. You will only read accolades in the local paper and hear accolades from sales people. Consider visiting a SHINE representative and have nonbiased dialog to find out what insurance is best for your situation.

I would not consider selecting a plan that restricts me and limits me to such a narrow range of doctors and services while boosting revenue.

Originally Posted by Garden guru (Post 1131349)

Th First of all, no snowbirds are going to join; they want a health care plan that will allow them to get medical care wherever they happen to be all year long, not just when they're here in TV. That right there eliminates half of TV population.

Originally Posted by FromDC (Post 1131237)

READ the following article. It is dated September 2014, but it is oh so relevant for today. The article talks about the Villages Advantage Plan as being a revenue generator:

**University of South Florida backed out from running the specialty care clinic due to lower than expected sales of the Plan.

**The business model relied on getting enough patients enrolled in the Plan. Only 6,000 enrolled, but they needed 20,000 enrolled the first year.

USF pulls out of its $4 million specialty care clinic at the Villages | Tampa Bay Times

If you want to enroll in this Advantage Plan because of Villages Health, go ahead. You will be helping their income stream. You will only read accolades in the local paper and hear accolades from sales people. Consider visiting a SHINE representative and have nonbiased dialog to find out what insurance is best for your situation.

I would not consider selecting a plan that restricts me and limits me to such a narrow range of doctors and services while boosting revenue.

Originally Posted by nkrifats (Post 1128371)

I would assume that those of us already in the system are grandfathered in. At least I do hope so.

Originally Posted by golfing eagles (Post 1129530)

:bigbow:Way too early for me to get it

Primum non nocere

Originally Posted by graciegirl (Post 1131892)

I didn't get it either. Je ne compris pas.

Originally Posted by memason (Post 1131106)

ok....this makes sense to me now. We already have UHC for our insurance, from my employer. Once we hit 65, we'll have to make some decisions on supplemental carriers.

Originally Posted by Mikeod (Post 1131367)

I think that enrollment in the UHC Advantage plan does not restrict a person to services only with the Villages Health Plan and can be used with network providers in their summer/home area as well. The Villages Health Plan is saying the UHC plans are the only ones they will accept. You are not contracting directly with them, only with UHC.

Originally Posted by golfing eagles (Post 1131895)

Latin in Hippocratic oath---"First do no harm"

Originally Posted by graciegirl (Post 1132354)

Got that part Doc, I took Latin. It's the post that you responded to that I didn't get.


All Gaul is divided into three parts.

Originally Posted by dotti105 (Post 1132298)

The Medicare Advantage Plan through The Villages, written by United Health Care does offer coverage in most other states. The only state we may have an issue in in Ca. as we have family there. If we need to be seen while there we may not have coverage.

For us, the states in which we would need coverage are all "in Network" except for Ca. The United Health Care offices can show you exactly where you will and will not be covered.

Originally Posted by FromDC (Post 1132500)

Are you saying The United Healthcare The Villages Medicare Complete 1 (HMO) is nationwide where you can visit almost any doctor? It is quite the opposite. An HMO is structured to have a very limited number of in-network providers. If you have an HMO plan and you become sick and need urgent care outside the network area, the plan will probably cover your emergency situation. If you have an HMO and you want an elective procedure done outside the network, you will probably pay the whole amount out of pocket. If you favor some of your doctors “from back home”, you better talk to your plan provider to see if they will or won't cover your elective care. I used the word 'probably' a lot, because using an out-of-network provider gets you into a gray area of who will pay for what. If you read the Plan summary, it is quite vague too.

Enter your zipcode on the Medicare.gov website. You will access the Advantage Plans you are allowed to sign up for. Stay on that website and do a columnar comparison of the original Medicare plan and the Advantage Plans you are interested in. Shop around, compare benefits, check out the providers, and costs.

Go see a SHINE volunteer representative and they will give you non-biased information and will guide you to your best options. Also, there is a great class at the Life Long Learning College that provides great information: Understanding Original Medicare and Medicare Options.

Do some homework and just don't hop in the golf cart and have an insurance agent tell you what is best for you. I guess I should mention that you should do this homework every year. Plans change and your health changes.

Originally Posted by golfing eagles (Post 1132504)

I agree. UHC offers 4 MA plans in Florida, the Villages MA 1 & 2 are both HMOs. The other 2 are PPOs. TV health only takes the HMO. So I would double and triple check the coverage network and participating providers. The concept of an HMO written with TV in mind would have nationwide coverage is questionable at best.

Originally Posted by golfing eagles (Post 1132504)

....UHC offers 4 MA plans in Florida, the Villages MA 1 & 2 are both HMOs. The other 2 are PPOs. TV health only takes the HMO.

Originally Posted by NYGUY (Post 1132617)

Not quite right Doc. The Villages Health now only accepts United Healthcare Medicare Advantage Plans and UHC's PPO's are Medicare Advantage Plans. I have a HUC Medicare Advantage PPO and have my email from TVH saying my insurance will continue to be accepted by TVH.

I might add, that in my opinion, UHC's PPO's are a much better option than UHC HMO's if a larger network of physicians (both primary and specialists) are important to someone as well as not requiring referrals in all cases.

Originally Posted by outlaw (Post 1132891)

Yesterday, I called three different people connected to TVH. My concern is that, although I am a patient with TVH, I am not yet 65 (God that sounds old, doesn't it?). I asked, when I became eligible for medicare, if I would be required to sign up for Med Adv, or would I be allowed to go with medicare plus supplemental. Two people said they didn't know. One person said yes. So, I still am not sure what will happen when I turn 65. And I guess, this whole thing with TVH going to UHC Med Adv is so new that the employees really don't know.

Originally Posted by CFrance (Post 1134726)

If you have a supplemental plan, anybody who takes Medicare must accept your supplemental (Medigap) plan. Don't see how they can get around that at TVH since it's the law.

Medigap works with the exact same network as Medicare. So you don't have to check the network if they accept Medicare.

https://www.senior65.com/medicare/ar...accept-medigap

Originally Posted by CFrance (Post 1134726)

If you have a supplemental plan, anybody who takes Medicare must accept your supplemental (Medigap) plan. Don't see how they can get around that at TVH since it's the law.